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Scores of web articles tout how easy and automatic going live with an Application Service Provider service can be. Enter reality check. Rum Chopra, a CIO that’s actively rolling out an ASP-based infrastructure for 14 disparate facilities knows otherwise. “You’re not going to be able to hand over the keys to the kingdom, and any CIO that starts out that way is going to be disappointed,” he explained in a recent interview.

He cited a systematic and orderly list of processes that can be applied to any ASP implementation. In this article we will look at how he moved through 12 steps of decision-making, going live and what he learned. “This is an IT implementation and should be treated with the same degree of care. You’ve got to do all the homework. It’s your responsibility to be a good customer,” he said.

Chopra has recently completed the final hurdles of an ASP implementation for his Chicago-based health services company, The C/N Group. AS CIO, he personally went through a comparative evaluation process to determine that ANDALON Health Systems would be the best-of-breed technology partner for The C/N Group. ANDALON is based in Amerherst, N.Y.

From discussions with Chopra and other ASP users, I have gleaned the following no-nonsense 12-step program for all CIOs:

1. Look at a minimum of three firms for the infrastructure, and software you would like to have deployed. Compare and contrast solutions.

2. Listen to the internal politics of your IT staffs, particularly if there are multiple facilities involved.

3. Select an internal test group to act as the company innovators, led by team members that can be the champions of change.

4. Before the implementation, make sure the ASP knows and understands your business practices, as it relates to deployment.

5. Realize that, in most cases, you are doing a whole rebuild of your IT infrastructure internally. Be aware of what software and hardware people are actually using, before you move to standardize.

6. Consider what security measures and levels of access will be appropriate and whether they can be provided by your ASP.

7. Know what you are paying for. Review pricing and consulting fees beforehand. Read all contracts.

8. Review your bandwidth requirements for a successful ASP implementation.

9. Let the ASP show you what planning it has done on your behalf, before your beta installs.

10. Work with the ASP for timely data conversions, where necessary. Some ASPs include this as part of their service. Some don’t.

11. Allow time and money for adequate internal training on the systems and software delivered by an ASP.

12. Know what your SLA means. Your Service Level Agreement may need to be adjusted in practice to meet your uptime needs.

Chopra said during his first assessment steps, he really narrowed down what the ASP model could offer, and which vertical ASP had the experience to understand his unique issues.

Back in September 1999 he had only a staff of 4.5 people dedicated exclusively to IT functions. “There was a great deal of decentralization and we were dealing with multiple locations,” he cited. The company has annual revenues of $20 million with approximately 92 employees. “We were a multi-headed monster. At the time, I realized it was going to be a real challenge to centralize functions and to have it work through a central point. For billing and collections, it had become tough to manage and costly. We needed to take our business to the next level,” he said.

Chopra had previously worked at Equifax where he was first exposed to an ASP concept. “I knew that a centrally-hosted model could work and I actually started by investigating recommendations from some of our top physicians.”
His selection was ANDALON Health Systems, a full-service, vertical ASP that focuses exclusively on the healthcare industry. The company hosts a number of industry software products including Image Medical’s Practice Builder for image management, and Medical Manager, a high-end physician practice management system.

“Andalon is an aggregator of ASP services. There are many ASP firms offering base connectivity and desktop tools. We looked at all of them, including Data Return, and UsiNetworking, but they just didn’t understand our business,” Chopra said.

He said that he knew from the beginning there as going to be more resistance against change at some facilities in his network versus others. “Physicians are a very strange breed of people. Going from film to a filmless approach in imaging can be traumatic. That made training critical,” he pointed out.

After internal interviews with several target facilities, he was able to determine five facilities that were open to new procedures. “We started with an Exchange 2000 implementation and we were impressed with the level of support from Andalon. Their team included the hiring of top notch people—healthcare IT professionals in their 40s and 50s—grizzled veterans with management experience,” Chopra said. He added that an internal review and site surveys by ANDALON revealed that certain personal software choices by physicians would have to be considered in the planning.

ANDALON did a complete site survey for each of the facilities which looked at hardware, how much RAM was needed, what was hooked up, and what software was running regularly. Chopra indicated that security discussions were handled early and intelligently by ANDALON. “Since they were a former IT shop before becoming an ASP, they had experience in all aspects of deploying a WAN, etc.”

While he did not experience had problems with connectivity, he indicated that many ASPs’ weakest link is their control over connectivity options which can cause delays of up to three months. “There are better and worse providers for connectivity. Find out who your ASP uses to provide this,” he suggested.

Lastly, pricing and Service Level Agreements have to be negotiated with care. There was some bargaining and a ‘not to exceed’ figure, he said. Training was part of his final agreement. “ANDALON had us contract separately for this service,” he added.